HomeMy WebLinkAboutSB989 Application 4-25-22R
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(Please note that these are separate
individual tests and will be charjed per
Separate type test acc-ordingly.)
PERMIT #
0 ENHANCED LEAK DETECTION 0 LINE TESTING
0 TANK TIGHTNESS X) FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DE,PARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 e Fax: 661-852-2171
Page 1 of 1
11 SB -989 SECONDARY CONTAINMENT
0 OVERFILL PREVENTION
SITE INFORMATION
FACILITY
USALiquor
UAMEI'ki���-832 # F
CO TPERSON
KamTUff
A00 11�O S Union, Bakersfield
OWNER NAME
Ali Morin
OPERATORNAMEPERMIT
Same
TO OPERATE #
OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? YES X No
TANK #
VOLUME'
CONTENTS
Tank 1
Tank 2
Tank 3
TANK TESTING COMPANY
TESTING COMPANY
LC Servlees
NAME & PHONE # OF CONTACT PERSON
-Bobbie Frank 559-444-1730
MAILING ADDRESS
3887 N. Valentine, Fresno, CA 93722
NAME at #0 TEST 0 SPECIAL INSPECTOR
C H;VKL RAS► E L
CERTIFICATION
B47431
TEST METHOD
In on
itc *
8357758
APPLICAN ATUR
DATE
2 10%5`2
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)